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Skin Tightening: Surgical vs. Non-Surgical

Little or no recovery time, minimal risk of infection or scarring, and very natural-looking results top the list of reasons why a non-invasive approach to skin tightening and rejuvenation are in such high demand. With the most advanced technology, I find that in many instances, the non-surgical approach is the most desirable for several reasons.

Little or no recovery time, minimal risk of infection or scarring, and very natural-looking results top the list of reasons why a non-invasive approach to skin tightening and rejuvenation are in such high demand. With the most advanced technology, I find that in many instances, the non-surgical approach is the most desirable for several reasons.

But there is no “one size fits all” approach to the aging face. The most appropriate treatment will depend on several factors including location on the face, quality of the skin, history of prior treatments, medical history, and ability to tolerate downtime.

Here are some of my favorite treatments to help lift and tone aging skin:

Ablative Fractionated Carbon Dioxide (CO2) Laser

Based on a laser used in the early and mid-1990s to vaporize the deepest wrinkles, today’s fractionated CO2 lasers are gentler to the skin, allowing for rapid healing and reduced side effects. This treatment is particularly good for tightening around the eyes. The so-called laser eyelift can deliver beautiful, natural-looking results without the “deer in the headlights” look that is sometimes seen after plastic surgery. Potential downsides: It may take more than one treatment to achieve the desired look, and the results don’t last as long as traditional plastic surgery.

Monopolar Radiofrequency (Thermage)

The Thermage procedure has been available for almost 10 years to non-invasively tighten skin around the eyes, jawline, chin and body. While the earliest treatments were quite painful and the results unpredictable, the most advanced techniques deliver appreciable tightening with minimal discomfort. Although the results are not as dramatic as a facelift, over 90% of patients obtain noticeable tightening of the treated areas and it never looks “pulled.” The procedure can be repeated every 1-3 years as needed to maintain the results.

Focused Ultrasound (Ulthera)

The most advanced technology involves focused ultrasound to visualize through the skin to target and treat deep support structures. Deep skin layers are targeted and heated to stimulate the growth of collagen, which gradually lifts the skin in 3-4 months. It is currently used for a non-invasive eyebrow lift and can be used to return definition to the jawline and improve the area under the chin. The ultrasound treatment can be quite effective to non-invasively rejuvenate the face; it is best performed using light pain medication to increase comfort during the treatment. As compared with plastic surgery, there is no cutting, no recovery, and all patients can resume their normal activities immediately. Several months after treatment, patients look refreshed and rejuvenated, never pulled. It’s suggested to repeat the treatment every 2-3 years to maintain the results.

Blog written by Elizabeth Tanzi, MD
Dr. Tanzi, Co-Director of the Washington Institute of Dermatologic Laser Surgery in Washington, DC, is an internationally...